ROCHESTER, Minn. — Three new articles from The Lancet Hematology published today examine how clinicians and researchers can better identify, track and measure the effects of blood cancer treatments on patients during treatment and over the long term.

Gita Thanarajasingam, M.D., a Mayo Clinic hematologist and oncologist, leads The Lancet Haematology's Adverse Events Reporting Series. The Series focuses on how clinicians care for people after treatment, how they measure treatment side effects and whether digital tools can help detect and manage those effects in real-world practice.

"Blood cancer treatments continue to become more effective and patients are living longer," says Dr. Thanarajasingam. "Just as we continue to evolve our treatments and detection in cancer, however, we need to evolve how we measure the effects on patients and their lives."

First launched in 2018, the Commission explores how newer treatments can be evaluated and whether new questions and tools can improve assessment. Current models for measuring treatment side effects may not adequately or consistently capture the duration and impact of symptoms on patients' lives. For example, a grading system might rank six months of mild nausea lower than four days of severe nausea without fully accounting for how a persistent symptom affects a patient's daily life.

The articles also examine the need for longer-term assessment. Many treatment studies measure outcomes only through five years after treatment, potentially leaving gaps in identifying and addressing health problems that emerge later. The reports suggest that cancer care should extend beyond treatment and that new approaches could help support patients’ health and quality of life during and after treatment.

The articles also describe how technology could support changes in how treatment effects are measured. Digital tools such as symptom-reporting apps, wearable devices and artificial intelligence could shift cancer safety monitoring from periodic assessments of what has already happened toward more continuous monitoring.

"Technology can enable new standards in care simply because it could offer more and real-time data," says Dr. Thanarajasingam. The report cautions, however, that new technologies are only a valuable catalyst if they are accurate, useful, equitable and built around patients.

"Complete cancer care is driven by the patient and their needs. For every therapeutic advance we make, we must also evolve our assessment standards and take advantage of new information to keep people's full and ideally, long lives at the core of our decision-making," says Dr. Thanarajasingam. "Just as we are now able to better personalize treatments, so, too, should we begin to address the whole person and their long-term needs."

For a complete list of commission members, disclosures and funding, review the articles in The Lancet Haematology.

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

Media contact:

• Julie Ferris-Tillman, Ph.D., Mayo Clinic Communications, newsbureau@mayo.edu

The post Mayo Clinic researcher leads Lancet commission reports on life during and after blood cancer treatment appeared first on Mayo Clinic News Network.

ROCHESTER, Minn. — Mayo Clinic researchers have estimated the risk that pancreatic cysts with worrisome or high-risk features will progress to pancreatic cancer or advanced precancerous changes within three years. The findings, published in Gastroenterology, could help physicians and patients better assess risk and make more informed decisions about whether to monitor a cyst or consider surgery. 

The prospective study found that risk increased with the number of worrisome features, or findings that the cyst needs closer monitoring. Patients whose cysts had one worrisome feature had about a 2% chance of developing pancreatic cancer or advanced precancerous changes within three years. The risk rose to 4% for those with two worrisome features and 18% for those with three or more. 

"This information will help us counsel patients. If we want to intercept pancreatic cancer while also sparing patients from unnecessary interventions, we must really know what is likely to become cancer and what is not," says Shounak Majumder, M.D., lead author and a gastroenterologist at Mayo Clinic.  

What does pancreatic cyst risk mean for patients?  

Pancreatic cysts are common and often discovered during imaging for an unrelated reason. Most do not become cancerous, but certain features seen on imaging can indicate a greater risk. Pancreatic cysts are classified as having high-risk features, worrisome features or neither. 

Pancreatic cysts without worrisome or high-risk features have a relatively low likelihood of progression to cancer. Cysts with high-risk features may prompt physicians to recommend surgery because of greater concern about cancer or advanced precancerous changes. Cysts with worrisome features often are monitored closely, although some may also require surgery.  

"Sometimes, we are unable to reliably determine whether a cyst will become pancreatic cancer or not," Dr. Majumder says. "That uncertainty creates a lot of anxiety for some patients undergoing surveillance, and some will opt for surgery." 

More precise estimates of progression risk can help patients and physicians weigh the potential benefits of surveillance and surgery.   

How did researchers determine pancreatic cancer risk?  

The study followed 230 people with pancreatic cysts that had worrisome or high-risk features. Unlike studies that look back at existing medical records or primarily include patients who underwent surgery, researchers enrolled participants and followed them over time, regardless of whether they chose surgery or surveillance. 

Of the 230 participants, 32 underwent surgery within the first three months after enrollment, and 198 entered clinical surveillance. Among those monitored, 185 had cysts with worrisome features, and 13 had cysts with high-risk features.  

The study found that patients with multiple worrisome features may represent a substantially higher-risk subgroup, while risk was not markedly elevated in patients with a single worrisome feature. 

Pancreatic cancers diagnosed among patients under careful surveillance were detected at a very early stage, suggesting that surveillance of appropriately risk-stratified patients may provide an opportunity to catch pancreatic cancer early. The finding suggests that regular surveillance may be an appropriate approach for some patients rather than immediate surgery. 

The three-year risk estimates also provide a benchmark for evaluating blood tests and designing studies of other approaches to early pancreatic cancer detection. 

Can blood tests and biomarkers predict pancreatic cancer risk? 

In a separate study led by Dr. Majumder and colleagues published in Clinical Gastroenterology and Hepatology, researchers examined CA 19-9, a blood biomarker that may be elevated in people with pancreatic cancer and is sometimes used to monitor pancreatic cysts. 

An elevated CA 19-9 result alone did not reliably predict which patients with pancreatic cysts would develop cancer. Among patients with low-risk cysts who had an elevated CA 19-9 level, none developed pancreatic cancer during the study's follow-up period. 

The findings suggest that a blood biomarker test should be considered with other information about a patient's health and cancer risk. They also underscore the need for new biomarker tests that can reliably detect the earliest stages of cancer in patients with pancreatic cysts. 

The data from these studies could help researchers design larger studies and clinical trials of new approaches to the early detection and prevention of pancreatic cancer as part of a broader effort at Mayo Clinic known as the Precure Research initiative.  

"The goal is more precise, personalized surveillance and an early detection approach that identifies patients who may benefit from earlier intervention while helping those at lower risk avoid unnecessary procedures and major surgery," says Dr. Majumder.  

For a complete list of authors, disclosures and funding, review the study.  

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About Mayo Clinic 
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news. 

Media contact:  

• Julie Ferris-Tillman, Ph.D., Mayo Clinic Communications, newsbureau@mayo.edu  

The post Mayo Clinic study estimates cancer risk in patients with pancreatic cysts, advancing early detection  appeared first on Mayo Clinic News Network.

As the fire chief for the city of Fargo, North Dakota, Gary Lorenz is accustomed to high-stress emergencies.  

"Firefighters are problem solvers," Gary explains. "When people call 911, and the dispatchers aren’t sure whom to send, they send the fire department."  

But on Oct. 7, 2025, Gary faced a crisis he could not simply delegate.  

During a routine scan for an unrelated issue, doctors discovered a tumor on his left kidney.  

Stunned by the news, Gary recalls pacing the floor at his headquarters fire station, feeling overwhelmed and not knowing what to do next.   

"I am kind of a fixer," says Gary. "Whether it's mechanical or other things, I'm fixing problems all the time, and so when it was my problem, trying to figure out how to fix this, it just seemed big."  

Walking in circles, the reality of his diagnosis set in.  

With the love and support of his wife, who works in the medical field, Gary discussed the next steps and knew exactly where to turn. He reached out to Mayo Clinic.  

Watch: Robotic surgery helps fire chief return to duty

Journalists: Broadcast-quality video (3:01) is in the downloads at the end of this post. Please courtesy: "Mayo Clinic News Network." Read the script.

A rapid response and a precise plan  

Within one day, a video conference was scheduled for the following week with Dr. Aaron Potretzke, a Mayo Clinic urologic surgeon.  

Knowing a plan was in place, his family urged him to go ahead with his annual fishing trip that weekend to Lake of the Woods in Canada.  

While driving, Gary received a call from Mayo Clinic asking whether he could meet virtually that Friday instead of the following week. 

During the videoconference, Dr. Potretzke explained how the scans described a single, approximately 4-centimeter bi-lobed tumor, but the exact nature of the growth would not be determined until after it was surgically removed.  

Because of the tumor's location and associated risks, Dr. Potretzke recommended a robotic-assisted radical complete nephrectomy, a minimally invasive surgery using robotic tools to completely remove a kidney through tiny incisions. 

"Dr. Potretzke’s thoroughness, professionalism and confidence greatly helped relieve much of the anxiety I was experiencing," says Gary.  

In short order, Gary received a call on Monday morning from Dr. Potretzke’s office about a last-minute surgical opening for the next day.  

Mayo staff coordinated and communicated with Gary to complete all of the necessary surgical preauthorization. 

Despite this tight timeline and a five-hour drive the night before, he was in the operating room exactly one week after his diagnosis.  

"It’s unheard of to go from start to finish that quickly," Gary says. "It felt like people actually cared how fast it came together."  

Dr. Potretzke says Gary's case was unique because of the multidisciplinary coordination that occurred in such a short time while Gary was several hours from Rochester, Minnesota. 

"To be able to get him into the operating room that fast was not something that we see every day, but it shows that this system works really well — and people at Mayo Clinic go the extra mile in an amazing way to take great care of patients in a thorough and efficient way," says Dr. Potretzke.  

Because of this advanced approach, he spent just a single night in the hospital and was able to return to work four days later.   

Dr. Potretzke will continue to monitor Gary over the next two years for signs of recurrence. 

Reaching a milestone: 100,000 da Vinci robot-assisted surgeries  

Gary's successful journey comes as Mayo Clinic marks a milestone in robotic-assisted surgery.  This summer, Mayo Clinic surpassed 100,000 surgeries assisted by the da Vinci robot.

Mayo Clinic uses advanced surgical robots to perform complex operations with precision, helping patients like Gary experience less pain, spend less time in the hospital and recover faster.  

"At Mayo Clinic in Arizona specifically, it's a marker of how far we've come as a campus from adopting the technology to now defining where complex robotic surgery goes next," says Dr. Michelle Nguyen, a Mayo Clinic transplant surgeon. "Reaching 100,000 cases is a meaningful milestone, but it's the culture of innovation behind it that will define what the next 100,000 look like."  

Much of that progress is being driven by breakthroughs in surgical technology. 

"Robotic-assisted surgery allows us to perform increasingly complex operations with greater precision, control and safety," says Dr. David Yang, a urologist at Mayo Clinic Health System in Mankato, Minnesota. "This translates into improved patient outcomes, less postoperative pain and faster recovery. Perhaps just as importantly, procedures that were once only available at large tertiary care centers can now be performed closer to home."  

That high level of care is a collective effort. 

"Each of those 100,000 robotic surgeries was made possible by our exceptional care teams, including not only surgeons at Mayo Clinic in Florida but nursing teams, anesthesia, surgical staff, custodial support, scheduling and many others," says Dr. Mara Piltin, a Mayo Clinic surgical oncologist. "Each member of our institution plays a meaningful role in allowing us to offer high-volume, high-complexity care to patients in need, and we are grateful for each piece of the puzzle."  

Grateful for the seamless multidisciplinary care  

Reflecting on his clear follow-up scans and rapid recovery, Gary is grateful for the seamless multidisciplinary care he received.   

Highlighting how technology empowers clinical teams, Dr. Potretzke notes that robotic-assisted surgery has been a tremendous asset.   

"Robotic surgery allows us to enhance traditional laparoscopy with 3D and magnified visualization, and articulating instruments that allow for meticulous dissection and sewing in very small spaces," he adds.  

Meanwhile, patients like Gary are thankful for the team at Mayo Clinic.   

"I told Dr. Potretzke I would only share my story if I could brag about him and his team," says Gary. "You really respect the knowledge and training that the care team has." 

The post When a fire chief needed help: How Mayo Clinic’s collaborative care and robotic surgery saved his life (VIDEO) appeared first on Mayo Clinic News Network.

JACKSONVILLE, Fla. — Mayo Clinic researchers have developed an experimental drug with the help of artificial intelligence (AI) to target the "undruggable" PDZ-domain of GIPC1 protein that helps different types of cancer, including pancreatic cancer, to grow and resist treatment. In laboratory studies, the drug slowed tumor growth, improved survival and enhanced the effects of the chemotherapy drug gemcitabine.

The findings, published in Cell Reports, also demonstrate how AI could help develop a small molecule inhibitor of a target protein that can be less toxic and speed the discovery of new cancer treatments.

Pancreatic cancer is one of the most difficult cancers to treat because it is often diagnosed after it has spread and is resistant to many current therapies. While survival rates remain low, advances in research are creating new opportunities to develop more effective treatments. This study represents one of those promising advances, offering a potential new strategy for targeting pancreatic cancer.

Using AI, in collaboration with Sravathi AI Technology for IP Sharing, a company based in Bangalore, India, the research team screened nearly 40,000 potential compounds before identifying one that blocks GIPC1. The experimental drug also showed early signs of changing the environment around tumors in ways that could improve future combination therapies. Additional studies are needed before it can be tested in people.

"Pancreatic cancer has remained exceptionally difficult to treat because tumors rapidly adapt and become resistant to many available therapies," says Debabrata (Dev) Mukhopadhyay, Ph.D., senior author of the study and a cancer researcher at Mayo Clinic in Florida. "Our study demonstrates that AI can help us identify entirely new therapeutic opportunities against targets that have historically been considered undruggable. While these findings are preclinical, they provide a strong foundation for the next phase of research."

The therapy remains experimental, and additional studies are needed to evaluate its safety and determine whether it can advance to clinical trials.

This research was supported in part by the National Institutes of Health, the Florida State Fund for the Casey DeSantis Cancer Research Program and the U.S. Department of Defense. For a complete list of authors, disclosures and funding, review the study.

###

About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

Media contact:

• Julie Ferris-Tillman, Ph.D., Mayo Clinic Communications, newsbureau@mayo.edu

The post First-in-class small molecule inhibitor designed with AI support shows promise against pancreatic cancer in preclinical studies appeared first on Mayo Clinic News Network.

ROCHESTER, Minn. — Mayo Clinic researchers have identified a protein that cancer cells use to shut down the body's immune response, a discovery that could help scientists develop new treatments that make cancer immunotherapies more effective.

Published in the Journal of Clinical Investigation, the study identifies a previously unknown role for a protein called TRAILshort, which acts like an immune "off switch." The researchers found that TRAILshort prevents T cells — the immune system's primary cancer-fighting cells — from recognizing and destroying cancer and virus-infected cells. In preclinical models, blocking the protein restored T-cell activity and improved immune response. 

The researchers also found that TRAILshort reduces the effectiveness of chimeric antigen receptor-T cell therapy (CAR-T cell therapy), one of the most advanced forms of cancer immunotherapy. Their findings suggest that therapies designed to block TRAILshort could improve CAR-T treatment and potentially benefit other immune-based cancer therapies.

"What strikes me most is that TRAILshort appears in cancer, HIV, COVID-19, tuberculosis, lupus and Crohn's disease — almost every condition where the immune system is failing or misfiring. That tells us we may have identified a fundamental switch in human immunity, not just a curiosity in one disease," says Andrew Badley, M.D., senior author of the study. Dr. Badley is the HH Sheikh Khalifa Bin Zayed Al Nahyan Professor of Infectious Diseases and an immunologist at Mayo Clinic.

How cancer disrupts the immune response 

Mayo Clinic researchers first discovered TRAILshort while studying HIV nearly 15 years ago. In 2020, they found that cancer cells also produce the protein, but how it suppressed T-cell activity remained unknown. This new study reveals the mechanism for the first time.

Researchers found elevated levels of TRAILshort in melanoma, lung, breast, pancreatic and ovarian cancers, as well as Hodgkin lymphoma. Elevated levels also were found in infectious diseases, including COVID-19, tuberculosis and hepatitis C.

Using highly specific antibodies and engineered preclinical models, the team found that TRAILshort activates SHP-1, a protein that acts as a molecular brake, shutting down T cells before they can attack diseased cells.

"This is the first study to show that TRAILshort doesn't just block cell death — it also acts as a signaling molecule that directly suppresses T-cell activity," says Shahrzad Jalali, Ph.D., a research scientist at Mayo Clinic and lead author of the study. "That reveals an entirely new role for the protein in regulating the immune response."

Why TRAILshort is a potential target for new therapies

The findings suggest several potential therapeutic applications.

Researchers found that TRAILshort significantly reduced CAR-T therapy's ability to control tumors in preclinical models. Blocking the protein restored immune activity, suggesting that targeting it could be a new strategy to improve CAR-T therapy and other immunotherapies. The researchers also believe that TRAILshort could serve as a biomarker to help identify tumors more likely to respond to targeted therapies.

"Discovering the role of TRAILshort and how it inhibits CAR-T cells opens the door for a new therapeutic strategy to improve their activity," says Saad Kenderian, M.B. Ch.B., an oncologist at Mayo Clinic Comprehensive Cancer Center and study co-author. "This is an important step as we work to make CAR-T therapy more effective for patients with cancer."

Beyond cancer, researchers say TRAILshort  may eventually provide a way to selectively reduce harmful immune activity in autoimmune diseases or transplantation without broadly suppressing the immune system.

"In cancer, there's too much TRAILshort, so our goal is to get rid of it with antibodies that remove it. In autoimmune disease, there's not enough TRAILshort, so our goal is to deliver more," Dr. Badley says.

Additional studies are needed to determine whether these approaches are safe and effective in patients.

"What excites us most is that this discovery gives us a new, actionable way to regulate the immune system," Dr. Badley says. "By targeting TRAILshort, we may be able to strengthen immune responses against cancer and chronic infections or, in other diseases, reduce harmful immune activity."

This research is part of a broader effort at Mayo Clinic known as the Precure Research initiative. It focuses on developing tools to help clinicians detect and address disease-related changes earlier, before symptoms appear or conditions become harder to treat. This discovery identifies the molecular mechanism behind T-cell failure across cancer and chronic infection, giving researchers a defined target and a road map for therapeutic development.

For a complete list of authors, disclosures and funding, review the study.

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

About Mayo Clinic Comprehensive Cancer Center
Designated as a comprehensive cancer center by the National Cancer Institute, Mayo Clinic Comprehensive Cancer Center is defining the cancer center of the future, focused on delivering the world's most exceptional patient-centered cancer care for everyone. At Mayo Clinic Comprehensive Cancer Center, a culture of innovation and collaboration is driving research breakthroughs in cancer detection, prevention and treatment to change lives.

Media contact:

• Julie Ferris-Tillman, Ph.D., Mayo Clinic Communications, newsbureau@mayo.edu

The post Researchers discover immune ‘off switch’ used by cancer cells  appeared first on Mayo Clinic News Network.

After serving others for 40 years through a legal career and now as a pastor and yoga teacher, Sandra Hedrick has led a life helping people. 

"I don't know what draws me to want to help people," she says. "I'm sure it's in my genes, but I really don't know."  

A self-described joyful yet introverted person, Sandra felt her busy life of mindfulness and gratitude stall three and a half years ago when an unexpected sinus issue developed. That fall, she and her husband were on a trip to see the changing leaves in North Carolina when she realized she could not breathe out of her right nostril.   

After her trip, Sandra visited internal medicine physicians about her sinus problem, who referred her to Dr. Osarenoma Olomu, an otolaryngologist at Mayo Clinic in Florida, for further evaluation.  

After a biopsy, pathology results showed the mass was esthesioneuroblastoma (ENB), a rare cancer also known as olfactory neuroblastoma (ONB). According to the National Cancer Institute, ONB affects approximately 1 in every 2.5 million people.   
 
Surgery was scheduled immediately following MRI confirmation of the size and location of the mass. 
 
"ONB is a fairly challenging mass to deal with because of where it lies: right at the base of the nose between the nasal airway and the brain," explains Dr. Olomu.  
 
As one of the nation's highest-volume centers for advanced head and neck cancers, Mayo Clinic in Florida manages complex and rare cases with precise, minimally invasive procedures. 

For Sandra's surgery, Dr. Olomu partnered with Dr. Kaisorn Chaichana, a neurosurgeon at Mayo Clinic in Florida, to perform an endoscopic resection and reconstruction through the nose.  

"This advanced approach allowed us to precisely remove the tumor while protecting the rest of the brain," explains Dr. Chaichana. "We worked together to resect and reconstruct at the same time." 

After surgery, Sandra had a course of radiation and two rounds of chemotherapy to conclude her initial treatment. Despite the physical discomfort she felt during this time, Sandra looks back on her postoperative treatment with fondness for her care team.  

"I experienced kindness in every way," she says. "The staff were highly professional and kind. They were just a joy to be with, even under the circumstances." 

Mayo Clinic care teams solve complex medical challenges, like Sandra's, by taking an approach that puts the patient at the center and incorporates experts from multiple medical disciplines. 

"When you work with a high-level team, you can make rare things not so rare," says Dr. Olomu. "Our team works together all the time as part of a nationally recognized center, so for a disease like ONB, we know a care pathway." 

After treatment, Sandra returned to her vocation as a pastor with reaffirmed compassion and a keener listening ear. She also participates in online ONB forums and conferences, connecting with others who share this uncommon bond and encouraging one another.  

Sandra approaches her follow-up scans with confidence that she is supported by a kind, caring and knowledgeable team. She is happy to return to life as a wife, friend and grandmother.   

"Being alive is nice, of course," says Sandra. "But I am not on any mission to accomplish anything. I want to thrive in my ordinary life. And that's what Mayo Clinic gave me." 

The post Rare cancer diagnosis affirms life committed to helping others appeared first on Mayo Clinic News Network.

DEAR MAYO CLINIC: My friend was recently diagnosed with leukemia, and I've learned there are several types. How do these differences affect her treatment options and decisions? 

ANSWER: It's true — leukemia isn't a single disease. It's a group of blood cancers, and the exact type plays a major role in how it's treated. Understanding these differences can help patients and families feel more informed and prepared. 

Leukemia is a cancer of the blood and bone marrow, where blood cells are made. Unlike cancers that start in one organ and spread, leukemia is usually considered a whole-body, or systemic, disease right from the beginning. 

In leukemia, the bone marrow produces abnormal white blood cells. These cells don't work properly and can crowd out healthy cells. This can lead to: 

• Fatigue and weakness (from low red blood cells). 

• Easy bruising or bleeding (from low platelets). 

• Frequent infections (from a weakened immune system). 

• Shortness of breath. 

• Bone pain or tenderness. 

• Swollen lymph nodes. 

• Enlarged liver or spleen. 

• Fever or chills. 

• Unintentional weight loss.  

Patients may overlook early leukemia symptoms because they may resemble symptoms of the flu and other common illnesses. 

Types of leukemia

There are four main types of leukemia: 

• Acute lymphocytic leukemia (ALL), which is the most common type of leukemia in young children, but it can also occur in adults. 

• Acute myeloid leukemia (AML), which is the most common type of acute leukemia in adults. 

• Chronic lymphocytic leukemia (CLL), which is the most common chronic leukemia in older adults. 

• Chronic myeloid leukemia (CML), which mainly affects adults of various ages. 

They're grouped based on how fast they grow and the type of blood cell involved:  

• Acute leukemias develop quickly and need urgent treatment. 

• Chronic leukemias grow more slowly and may not need treatment right away. 

• Lymphocytic leukemias affect lymphocytes, a type of white blood cell involved in the immune system.  

• Myeloid leukemias affect cells that develop into red blood cells, platelets and other types of white blood cells.  

Each type — and even subtypes within them — can behave quite differently. For example, some people may have a slow-growing form of CLL that may not need treatment for years, while others may have a faster-growing subtype that requires treatment soon after diagnosis. 

Diagnosis

Diagnosis often begins with a routine blood test that shows abnormal cell counts. If leukemia is suspected, a bone marrow biopsy — taking a small sample from the hip bone — is usually needed to confirm the diagnosis. From there, more detailed testing is done, including: 

• Flow cytometry to identify cell types. 

• Cytogenetics to study chromosomes. 

• Molecular testing to look for genetic changes. 

Accurate diagnosis is essential because different types of leukemia require different treatments. Some therapies work only for certain genetic markers, and the expected outcome can vary widely. These tests allow doctors to match patients with therapies that target their specific disease, making leukemia treatment highly individualized.  

Treatment

Treatment may include: 

• Chemotherapy, a drug treatment that uses powerful chemicals to kill fast-growing cells in your body. 

• Targeted therapy, a treatment that uses medicines that attack specific targets in the cancer cells.  

• Immunotherapy, treatments that help the immune system fight cancer. These include CAR-T cell therapy — engineered immune cells that attack cancer cells — and bispecific antibodies that help immune cells find cancer cells. 

• Stem cell transplantation, a treatment that replaces diseased bone marrow with healthy cells, often using donor cells. 

When deciding the best treatment, doctors consider several factors, including: 

• The exact type and subtype of leukemia. 

• Genetic and molecular test results. 

• How quickly the disease is progressing. 

• The patient's age and overall health. 

• The patient's personal preferences. 

The future of leukemia treatment is focused on precision medicine — tailoring treatments to the genetic makeup of each patient's leukemia — and improving long-term outcomes with fewer side effects. With advances in testing and therapy, care is becoming more personalized than ever, offering hope for even better results in the coming years.  

William Hogan, M.B., B.Ch., Hematology, Mayo Clinic, Rochester, Minnesota 

The post Mayo Clinic Q&A: Why leukemia type matters for treatment decisions appeared first on Mayo Clinic News Network.

PHOENIX — An international phase 3 study performed at all three Mayo Clinic destination medical centers found that a new immunotherapy helped many patients with an aggressive form of bladder cancer keep their bladder instead of having it surgically removed. The treatment also kept many patients cancer-free for more than two years and caused mostly mild side effects. The findings were published in The Lancet Oncology.

Patients in the study had high-risk bladder cancer that had returned despite standard treatment with bacillus Calmette-Guérin (BCG). For these patients, surgery to remove the bladder is typically the recommended next step. The new immunotherapy treatment, called cretostimogene grenadenorepvec, produced a complete response, with no detectable signs of cancer in 75% of patients, with many of those responses lasting beyond two years.

"Until now, patients whose cancer returned after BCG therapy have had few effective options besides bladder removal," says Mark Tyson II, M.D., lead author of the study and a urologist at Mayo Clinic in Arizona. "This study shows we may be able to offer many of those patients another option without compromising cancer control."

Among patients whose cancer completely disappeared after treatment, about 60% remained cancer-free two years later. In one patient, the cancer has not returned for more than four years after completing treatment. Most treatment-related side effects were mild, temporary bladder symptoms, and researchers reported no severe treatment-related side effects.

"For patients, this isn't just about treating cancer — it's about preserving quality of life," says Dr. Tyson. "Avoiding bladder removal can have a profound impact on daily living. Seeing patients remain cancer-free for years while keeping their bladder is exactly the outcome we've been hoping to achieve."

The study included 115 patients treated at 41 medical centers across North America, Asia and Australia. Two years after starting treatment, an estimated 81% of patients had not needed surgery to remove their bladder. The researchers concluded that cretostimogene grenadenorepvec could become an important bladder-sparing treatment option for patients whose high-risk bladder cancer has returned after standard BCG therapy. They also noted that the treatment has not been directly compared with other bladder-sparing therapies in clinical trials.

The study was funded by CG Oncology. For a complete list of authors, disclosures and funding, review the study. The therapy remains investigational.

###

About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

Media contact:

• Julie Ferris-Tillman, Ph.D., Mayo Clinic Communications, newsbureau@mayo.edu

The post Experimental immunotherapy may help patients with high-risk bladder cancer avoid bladder removal surgery appeared first on Mayo Clinic News Network.

DEAR MAYO CLINIC: My neighbor recently had an X-ray after hurting their leg, and the doctor found a bone lesion that needs more testing. They're terrified it could mean bone cancer. It got me wondering: Does every bone tumor or bone lesion mean cancer?  

ANSWER: Hearing that an imaging test found a bone tumor or bone lesion can be frightening. Fortunately, most bone tumors aren’t cancerous. The key is finding out exactly what type of tumor or lesion you have, so your healthcare team can recommend the right care. 

A bone tumor is an abnormal growth of cells within the bone. Some bone tumors are benign (noncancerous) and may simply be monitored over time. Others are malignant (cancerous) and require treatment because they can grow, damage the bone or spread to other parts of the body.  

It's also important to understand that primary bone cancer is different from cancer that has spread to the bone from another part of the body. Cancers are named for where they begin. For example, if lung cancer spreads to the bone, it's still lung cancer, not bone cancer. Likewise, if bone cancer spreads to the lungs, it's still bone cancer.  

Knowing where a cancer began helps your healthcare team recommend the most appropriate treatment. Primary bone cancers are also usually not caused by something you did or didn't do, which can be reassuring to know. 

Pain in your bones, muscles or joints is common and is usually caused by conditions other than cancer. However, pain that continues to worsen, doesn't improve over time, wakes you from sleep or is associated with other symptoms, such as swelling, fever, weight loss or limping, deserves medical evaluation. 

In children and teenagers, persistent pain shouldn't automatically be dismissed as growing pains. While growing pains are common, ongoing pain that interferes with sports, school or daily activities should be evaluated by a healthcare professional.  

Persistent back pain in children is also uncommon and should be checked. Another warning sign is a fracture that occurs after little or no trauma. Some bone tumors can weaken the bone enough that it breaks more easily than expected. 

Sometimes bone tumors don't cause symptoms at all. Instead, they’re discovered when an X-ray or other imaging test is performed after a sports injury or another unrelated problem. In these situations, the injury didn't cause the tumor; the imaging simply revealed something that was already there. 

When a bone tumor or lesion is found, your healthcare team will review your medical history, perform a physical examination and determine whether additional imaging, such as a CT scan or MRI, is needed to better understand the abnormality. Based on those imaging findings, a biopsy may be recommended. 

During a biopsy, a small tissue sample is removed and examined under a microscope to determine exactly what type of cells are present. The biopsy results help your healthcare team make an accurate diagnosis and recommend the most appropriate treatment. Waiting for answers can be difficult, but taking the time to make an accurate diagnosis helps ensure you receive the most appropriate treatment. 

Treatment depends on the type of bone tumor. Many benign tumors don't require treatment and can simply be monitored if they're not causing pain, limiting function or weakening the bone. Other benign bone tumors may require surgery. Malignant bone tumors, however, require treatment. Depending on the type of cancer, treatment may include surgery, chemotherapy, radiation therapy or a combination of these approaches. 

Because bone tumors are rare, it's important to be evaluated by a healthcare team with experience diagnosing and treating your specific condition. Specialists, including radiologists, pathologists, orthopedic surgeons and medical oncologists, work together to make an accurate diagnosis and recommend the most appropriate treatment plan. 

If you've been told you have a bone tumor or bone lesion, try not to assume the worst. Many bone tumors are benign, and even malignant bone cancers can often be treated successfully. If you have persistent pain, an abnormal imaging finding or symptoms that concern you, don't ignore them. Talk with your healthcare team. An accurate diagnosis is the first step toward getting the care that's right for you. 

Wendy Allen-Rhoades, M.D., Ph.D., Oncology, Mayo Clinic, Rochester, Minnesota

The post Mayo Clinic Q&A: Does a bone tumor always mean cancer? appeared first on Mayo Clinic News Network.

Mayo Clinic oncologist explains risk factors, treatment considerations for patients under 50

PHOENIX — You may have heard that colorectal cancer is increasingly affecting young adults. However, it is not the only gastrointestinal (GI) cancer that doctors are diagnosing in patients below the age of 50, explains Christina Wu, M.D., an oncologist at Mayo Clinic Comprehensive Cancer Center in Arizona.

"People under 50 are not too young to develop gastrointestinal cancers," Dr. Wu says. "If young adults notice new or persistent symptoms, it's important to get them worked up."

At Mayo Clinic, early-onset gastrointestinal cancers are defined as GI cancers diagnosed in people under 50 years old. Research shows that the most common type of early-onset GI cancer worldwide is colorectal cancer, followed by stomach cancer, esophageal cancer and pancreatic cancer. Less common types of early-onset GI cancers include bile duct, gallbladder, appendix, neuroendocrine and small bowel cancers.

"More research needs to be done to understand what causes the rise in incidence of early-onset GI cancers," Dr. Wu says. "We know that certain factors can increase the risk of developing GI cancers, and early detection gives patients a better chance of successful treatment."

Risk factors

Several factors can increase the risk of developing early-onset GI cancers, including genetic conditions, chronic diseases and lifestyle:

• Lynch syndrome and familial adenomatous polyposis are hereditary conditions that are associated with an increased risk of early-onset colorectal cancers.

• Inflammatory bowel disease and primary sclerosing cholangitis can increase the risk of developing GI cancers such as colorectal cancer and cholangiocarcinoma, respectively.

• A sedentary lifestyle, obesity, diets high in processed foods, alcohol consumption, smoking and environmental exposures may be associated with an increased risk of GI cancers.

Early detection and symptoms

Recommendations for when people at average risk for colorectal cancer should be screened vary by country but generally start in their 40s or early 50s. In the U.S., colorectal cancer screening is recommended to start at age 45 for people at average risk; people with risk factors such as a family history of colorectal cancer may need to start screening earlier.

Having a primary care clinician, getting regular health checkups and discussing any health concerns with a healthcare professional can help determine what screening or tests may be needed, depending on individual risk factors.

In some cases, symptoms of early-onset GI cancers may present and be associated with specific cancer types:

• Unintentional weight loss with jaundice and pain may indicate pancreatic cancer.
• Weight loss, pain, and difficulty eating or swallowing may be linked to stomach cancer.
• A persistent change in bowel habits, abdominal pain and iron-deficiency anemia may be associated with colorectal cancer.

"Any new symptoms that are persistent or worrisome should prompt a visit to a healthcare professional to get checked out," Dr. Wu says. "If symptoms are ignored or not investigated, young adults may experience a delay between when they first experience symptoms and a cancer diagnosis. Recognizing symptoms early is important," Dr. Wu explains.

Tailoring care for younger adults  

Young adults diagnosed with GI cancers often need multidisciplinary care due to differences in cancer biology, as well as unique social and life-stage needs.

"Before starting treatment, we perform genetic testing and tumor profiling to identify mutations that may guide targeted therapies," says Dr. Wu. "These advances allow us to provide more personalized and effective treatment for our patients."

In addition, young adults may require support, such as fertility preservation and resources to navigate the emotional and practical challenges of a cancer diagnosis. Mayo Clinic's Early-Onset and Hereditary GI Cancers Program provides specialized, multidisciplinary care for this patient population.

Innovations in treatment

With advances in genetic testing and tumor profiling, cancer care teams can provide more personalized and targeted treatments, including immunotherapy in some cases, and identify patients who may be eligible for clinical trials. Analysis of the tumor helps guide treatment decisions and identify appropriate therapies.

For certain GI cancers, treatment may involve a combination of chemotherapy, radiation (including proton beam therapy) and surgery. Advances in treatment, including minimally invasive approaches and immunotherapy, are improving care for some GI cancers.

Mayo Clinic researchers have been exploring the use of artificial intelligence as an additional aid in the detection of gastrointestinal cancers such as colorectal cancer and pancreatic cancer.

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

Media contact:

• Caroline Auger, Mayo Clinic Communications, newsbureau@mayo.edu

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